Medical Home

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The patient centered medical home aims to redesign primary care practices to ensure accessible, timely, comprehensive, patient-centered primary care and effective coordination with other providers.  The prevailing medical home concept is represented in both the Joint Principles put forth by the four primary care physician professional organizations (American Academy of Family Physicians, American Academy of Pediatrics, American College of Physicians, American Osteopathic Association) in 2007 and the National Committee for Quality Assurance (NCQA) standards for recognition as a patient centered medical home.

The patient-centered medical home plays an important role in health reform at both the state and national levels.  Given that health centers are experts in and serve as models for community based comprehensive primary care, they should be engaged in medical home developments.   It is important to know that thirty or more state Medicaid agencies have already legislated medical home initiatives with many fully engaged in demonstrations and the Medicare-Medicaid Advanced Primary Care Demonstration Initiative was announced in September 2009. The Safety Net Medical Home Initiative,  a five-year demonstration launched by the Commonwealth Fund, Qualis Health and the MacColl Institute for Healthcare Innovation, relies heavily on health center organizations; four primary care associations lead or co-lead the regional coordinating centers for this effort.

To function as high performing medical homes, providers of care, employee health programs and public health and social service agencies should be integrated to care for a defined population over time. Payment should be based on health outcomes, quality and reduced costs as opposed to volume and intensity of services.  This concept is known as an Accountable Care Organization (ACO).  Demonstrations or pilots of ACOs are included in the current major health reform bills before the Congress.

NACHC has collected a set of central resources that provide background on the patient centered medical home concept and capture its evolving significance for safety net providers.

E-mail Katja Laepke with questions, suggestions or corrections.